Depression, epilepsy and some more pop sociology: Joy Division and Ian Curtis (updated)

Cover of "Unknown Pleasures (Bonus CD) (R...
Cover of Unknown Pleasures (Bonus CD) (Reis)

In this piece (which started out considering the psychological value of play, idleness, and boredom), I wondered if “there [was] something significant in the fact that all of these bands emerged from the industrialised north of England during the 1970’s and 1980’s (Morrissey – Manchester; The Specials – Coventry; Pet Shop Boys – Newcastle and Blackpool) during a time of the collapse of traditional industry and huge unemployment? Where traditional roles in shipbuilding, mining, manufacturing or whatever were disappearing, and there was nothing else to do, except perhaps turn inwards and be creative?”

Of course, I forgot a particularly important group from Salford, a town just outside of Manchester: Joy Division, who over time became New Order. They date from the 1976-1980 era – again a time of great industrial unrest and economic uncertainty, with old job prospects disappearing quickly.

Joy Division’s lead singer Ian Curtis suffered from very severe epilepsy with a comorbid, very profound and recurrent depression (more on this relationship below), and would eventually commit suicide at the age of just 23. Curtis wrote or co-wrote most of the band’s songs, exploring the darkness within. Joy Division left just two transcendent studio albums (Unknown Pleasures and Closer; the album covers alone are works of art). Joy Division had one stunning chart success in ‘Love Will Tear Us Apart‘:

After Curtis’ death, Joy Division went on as New Order – a band of eclectic electronic and other outputs, having huge success with ‘Blue Monday‘:

While not often recognised popularly, it is the case that depression and epilepsy often co-occur. The presence of one can also exacerbate the other, increasing risk of morbidity substantially. The abstract from one important review of the relationship between the two is below:

Depression is the most frequent comorbid psychiatric disorder in epilepsy. Its lifetime prevalence has been estimated at between 6% and 30% in population-based studies and up to 50% among patients followed in tertiary centers. The risk of suicide has been estimated to be 10 times higher than that in the general population. Although no one questions that epilepsy is a risk for depression, recent studies have also revealed that a history of depression is associated with a 4- to 6-fold greater risk of developing epilepsy. These data suggest either a possible “bi-directional” relationship between these two disorders or the presence of common pathogenic mechanisms that facilitate the occurrence of one in the presence of the other. The clinical presentation of depressive disorders in epilepsy can be identical to that of nonepileptic patients and can include major depression, bipolar and dysthymic disorders, and minor depression. In a significant percentage of cases, however, the clinical features of depression in epilepsy fail to meet any of the DSM-IV Axis I categories. Depression in epilepsy may be iatrogenically induced with various antiepileptic drugs used to treat the seizure disorder or after surgical treatment of intractable epilepsy. Despite its relatively high prevalence, depression remains unrecognized and untreated, and unfortunately its treatment is based on empirical and uncontrolled data.

Another paper (pdf) concludes that ‘Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy.’

Update: Katy reminded me of Anton Corbijn‘s wonderful film Control, shot in beautifully in black and white, which focuses heavily on Ian Curtis. Here’s a piece:

Author: Shane O'Mara

Neuroscientist

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